Abstract
This is the first case report of a pediatric blunt abdominal aortic injury in Japan. A 12-year-old boy was crushed between 2 personal watercrafts on a lake. Initially, an emergency medical service vehicle transported him to a neighboring hospital. Plain computed tomography (CT) scan revealed retroperitoneal hematoma, and the doctors suspected a major vascular injury. Two hours after the event, the patient was transferred to our hospital by air rescue. Contrast-enhanced CT scan performed on arrival revealed an abdominal aortic injury. Aortagraphy revealed a pseudoaneurysm formation and extravasation from the aortic bifurcation. We inserted an occlusion balloon catheter into the infrarenal aorta. We inflated the balloon and blocked the infrarenal aortic blood flow. He was immediately transferred to the operating room. Under blockade of the aortic blood flow, the retroperitoneal cavity was opened. We observed that the posterior wall of the terminal aorta was split longitudinally by approximately 2 cm. This laceration was repaired using primary sutures. The postoperative course was uneventful. Preoperative occlusion balloon catheter blockade is effective in attenuating hemorrhage from the abdominal aorta; although it is difficult to apply this catheter in a child because of the narrowness of the aorta.
